L5618 — Addition to lower extremity, test socket, symes
HCPCS Level II L-code · short descriptor: “Test socket symes”
- Code system
- HCPCS Level II
- Family
- L — Orthotics & prosthetics
- Medicare coverage status
- Carrier judgment — coverage decided by the DME MAC
- DMEPOS payment category
- Prosthetics & orthotics
- Prior authorization
- Not on Medicare required-PA list
- Status
- Active (April 2026 HCPCS)
Prior authorization
Not on the Medicare required-PA list as of the January 13, 2026 update (74 items). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.
L5618 Medicare fee schedule (April 2026)
Base (no modifier) Prosthetics & orthotics
Medicare allowable ranges from $319.44 to $459.08 depending on state and rural status.
Former-CBA payment limits: ceiling $459.08 · floor $344.31
| State | Non-rural | Rural |
|---|---|---|
| AK | $347.81 | — |
| AL | $366.46 | — |
| AR | $369.85 | — |
| AZ | $353.52 | — |
| CA | $353.52 | — |
| CO | $344.31 | — |
| CT | $459.08 | — |
| DC | $387.38 | — |
| DE | $387.38 | — |
| FL | $366.46 | — |
| GA | $366.46 | — |
| HI | $371.91 | — |
| IA | $364.14 | — |
| ID | $382.45 | — |
| IL | $411.43 | — |
| IN | $411.43 | — |
| KS | $364.14 | — |
| KY | $366.46 | — |
| LA | $369.85 | — |
| MA | $459.08 | — |
| MD | $387.38 | — |
| ME | $459.08 | — |
| MI | $411.43 | — |
| MN | $411.43 | — |
| MO | $364.14 | — |
| MS | $366.46 | — |
| MT | $344.31 | — |
| NC | $366.46 | — |
| ND | $344.31 | — |
| NE | $364.14 | — |
| NH | $459.08 | — |
| NJ | $362.87 | — |
| NM | $369.85 | — |
| NV | $353.52 | — |
| NY | $362.87 | — |
| OH | $411.43 | — |
| OK | $369.85 | — |
| OR | $382.45 | — |
| PA | $387.38 | — |
| PR | $319.44 | — |
| RI | $459.08 | — |
| SC | $366.46 | — |
| SD | $344.31 | — |
| TN | $366.46 | — |
| TX | $369.85 | — |
| UT | $344.31 | — |
| VA | $387.38 | — |
| VI | $362.87 | — |
| VT | $459.08 | — |
| WA | $382.45 | — |
| WI | $411.43 | — |
| WV | $387.38 | — |
| WY | $344.31 | — |
Amounts are the Medicare DMEPOS fee-schedule allowables effective April 2026.
Medicare typically pays 80% of the allowable after the Part B deductible; the patient owes 20%.
A 2% sequestration reduction applies to the Medicare share. Former competitive-bidding-area
adjustments and non-continental rates can differ — verify with your DME MAC.
Common denial codes to watch
Related L-codes
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